Type of hysterectomy does not impact on sexual problems

Reported by Susan Aldridge, PhD, medical journalist

A review shows that there is no difference after total and sub-total hysterectomy when it comes to sexual, urinary and bowel difficulties.
Hysterectomy is a common procedure for treating fibroids and heavy bleeding. Women can either have a total hysterectomy, in which the uterus and cervix are removed, or a sub-total hysterectomy where the cervix is left behind. The former is a more complex and lengthy procedure, while the latter is linked to ongoing menstrual bleeding.

What's not been certain is how the type of hysterectomy affects the likelihood of sexual, urinary and bowel problems afterwards.  A team at the University of Auckland, New Zealand, has reviewed studies covering 733 women having one or other of the procedures. They find no evidence that removal of the cervix impairs sexual function. Satisfaction with sex, prevalence of painful intercourse and rates of sexual problems in the year or two after surgery did not vary with the type of hysterectomy. Nor was there in difference in rates of urinary or bowel problems.

The study did confirm that ongoing menstrual bleeding is an issue in sub-total hysterectomy - affecting 12 per cent of women. For those opting for a total hysterectomy, ongoing bleeding occurred in less than one per cent of cases. However, the researchers consider the number of women studied in this comparison as relatively small. They would like to see more research comparing the two approaches to hysterectomy.

Source
The Cochrane Database of Systematic Reviews May 2006

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